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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Gentamicin is the recommended aminoglycoside for empirical treatment of serious neonatal and pediatric infections. Optimal therapy requires achieving high peak concentrations to maximize antibacterial efficacy while maintaining low trough levels to prevent oto- and nephrotoxicity. However, the ongoing maturation of renal function introduces substantial pharmacokinetic variability across pediatric age groups. Despite notable differences among national dosing guidelines, it remains uncertain whether these regimens ensure both effective and safe therapy across all ages.
This in-silico study compares Gentamicin target attainment in pediatric populations across four national guidelines: Egyptian, Saudi Arabian, Malaysian, and Dutch.
We simulated gentamicin exposure in 9,000 virtual patients (age: 1 day-10 years) based on a meta-analysis of published pediatric pharmacokinetic models and measured glomerular filtration rate (mGFR) data. Anthropometric parameters were sampled from the World Health Organization (WHO) growth standards. Patients were divided into three age groups: neonates (N = 2,000; age 1-28 days; median [IQR] weight 3.3 kg [2.9-3.7]; mGFR 33 mL/min/1.73 m² [24-42]), infants (N = 3,000; age 1-12 months; weight 6.0 kg [4.8-7.2]; mGFR 58 mL/min/1.73 m² [49-70]), and children (N = 4,000; age 1-10 years; weight 13.8 kg [10.5-20.4]; mGFR 92 mL/min/1.73 m² [81-103]). For each population, dosing regimens and target attainment were evaluated according to four national guidelines.
Peak and trough target attainment varied strongly across both national guidelines and age groups (Figure 1). Peak concentration in neonates remained below the target for the Egyptian, Malaysian, and Dutch guidelines (59%, 99%, 21% below target, respectively), whereas they were starkly above the target for the Saudi Arabian guidelines (79% above target). A large fraction of infants and children fell below the peak target (23% - 96% below target for infants, and 42% - 93% below target for children), with the Malaysian and Dutch guidelines yielding higher mean peak levels in these age groups (mean 15.8mg/L ) compared to the Egyptian and Saudi Arabian guidelines (6.6mg/L). Through target levels varied drastically among guidelines. A considerable fraction of neonates (26%-81%) and infants (18%-91%) exceeded the recommended trough target, while children remained within target ranges, except under the Egyptian guidelines, where 99% exceeded the trough target compared to 1%-30% under other guidelines.
Differences in national dosing guidelines result in variability in peak and trough levels with associated expected variability in treatment efficacy and nephrotoxic risks. Substantial proportions of the pediatric population are not meeting suggested trough targets across all guidelines. Drug exposure varies markedly across age groups, reflecting post-natal renal maturation; a factor not fully accounted for in current national dosing guidelines. Harmonizing dosing guidelines to consider renal maturation could reduce nephrotoxicity and optimize therapeutic outcomes in pediatric care.
